Transabdominal amnioinfusion in preterm pregnancies complicated by fetal growth restriction, oligohydramnios and umbilical cord compression.

ABSTRACT

Fetal growth restriction with oligohydramnios occurring in the preterm gestation is associated with significant fetal morbidity and mortality. We investigated the possibility that transabdominal amnioinfusion might relieve acute cord compression and allow prolongation of gestation long enough to administer corticosteroids. Four patients with fetal growth restriction, oligohydramnios and evidence of significant cord compression with otherwise reassuring fetal heart rate testing underwent transabdominal amnioinfusion. Pregnancy was prolonged 22, 38, 10 and 9 days, and cord compression was relieved in all cases. One patient showed findings consistent with reversal of chronic hypoxemia with stabilization of amniotic fluid index measurements in the normal range and normalization of fetal growth. Transabdominal amnioinfusion may be useful as an adjunctive technique to prolong pregnancy in preterm gestations with fetal growth restriction, oligohydramnios and evidence of umbilical cord compression.